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CMS F-Tag · 42 CFR §483.10(i), Safe Environment · Resident Rights

Safe, Clean & Homelike Environment

Cited for F584? Here's what surveyors were looking for, how serious it tends to be, and how to structure a Plan of Correction that holds up.

Paul Richards, RN, MSHI·Founder, EasyPOC·✓ Clinically reviewed·Updated Jul 6, 2026
#10
Most-cited nationally

Citation figures from the CMS Provider Data Catalog. Rank reflects the most recent CASPER data.

What the regulation says

42 CFR §483.10(i), Safe Environment
§483.10(i) Safe Environment. The resident has a right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. The facility must provide: §483.10(i)(1) A safe, clean, comfortable, and homelike environment, allowing the resident to use his or her personal belongings to the extent possible... §483.10(i)(2) Housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior; §483.10(i)(3) Clean bed and bath linens that are in good condition.
Verbatim from the CMS State Operations Manual, Appendix PP.

What F584 actually means

F584 is the environment tag, it covers whether the facility is clean, well-maintained, comfortable, and homelike. It's cited on the environmental tour from what surveyors see and smell: damaged walls and furniture, soiled floors, strong odors, stained linens, broken fixtures, clutter. None of it is about clinical care, which is exactly why it's frustrating to be cited for, it's usually a housekeeping and maintenance follow-through problem, not a knowledge gap.

What surveyors check

A tour of resident rooms, bathrooms, common areas, and corridors. Cleanliness of floors, surfaces, and vents; maintenance and condition of walls, furniture, and fixtures; odors; condition and cleanliness of linens; functioning equipment; and whether the environment supports a homelike, comfortable setting rather than an institutional or neglected one.

What most often triggers it

  • Damaged or soiled walls, floors, or furniture in resident areas
  • Strong or persistent odors in rooms or corridors
  • Stained, torn, or worn bed and bath linens
  • Broken fixtures, call lights, or equipment left unrepaired
  • Dirty vents, baseboards, or high-touch surfaces

How serious is it? Scope & severity

F584 is almost always cited at D–F, an environmental gap with potential for more than minimal discomfort or harm, but no injury. It rises toward the harm range only in the uncommon case where an environmental condition contributes to an actual safety event.

Severity ↓ / Scope →
Isolated
Pattern
Widespread
Immediate Jeopardy
J
K
L
Actual harm
G
H
I
No harm, higher potential
D
E
F
No harm, minimal potential
A
B
C

The CMS scope & severity grid runs from an isolated no-harm gap (A) up through widespread Immediate Jeopardy (L). The level a surveyor assigns drives how urgent and far-reaching your Plan of Correction must be.

Example citation

F584 · Illustrative composite
Based on observation, the facility failed to maintain a clean and comfortable environment in 3 of 12 resident rooms toured. Room 210 had a large area of damaged, exposed wallboard beside the bed; Room 214 had a strong, persistent urine odor at both observations; and the shared bathroom serving Rooms 210–212 had visibly soiled flooring and a stained shower curtain.
Illustrative example, not a real facility.

How to write the Plan of Correction

(1) Correct the specific findings cited, repair, clean, or replace. (2) Identify scope: conduct a facility-wide environmental audit for the same conditions. (3) Systemic change: establish or revise housekeeping and preventive-maintenance schedules with clear accountability and a work-order follow-through process. (4) Monitoring: leadership conducts environmental rounds on a defined schedule, tracking findings to resolution through QAPI.

Cited for F584? Draft your Plan of Correction now.

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Common questions

What is F584?+

The CMS tag for a safe, clean, comfortable, and homelike environment, under 42 CFR §483.10(i).

What most commonly triggers it?+

Damaged or soiled surfaces, odors, and worn linens found on the environmental tour.

How serious is it?+

Almost always a no-harm "D–F."

How do you respond?+

Correct the findings, audit facility-wide, tighten housekeeping and maintenance accountability, and conduct environmental rounds.

Related tags

This page is a compliance reference and does not constitute legal or clinical advice.